2 Current regulatory activities
The remit
of the HCPC
3. The HCPC was established by Parliament under
the Health and Social Work Professions Order 2001. Its predecessor,
the Council for Professions Supplementary to Medicine (CPSM),
was established in 1961. The HCPC states that:
Our main objective is to safeguard the health
and wellbeing of persons using or needing the services of our
registrants and we do this by:
- setting and maintaining standards for professional
skills and conduct;
- maintaining a register of professionals who meet
these standards;
- approving and monitoring education programmes
leading to registration; and
- taking action when a registrant's fitness to
practise falls below our standards.
We also protect professional titles, with all
the professions having at least one protected title. It is a criminal
offence for someone to claim to be registered when they are not,
and we take action against those who do so.[4]
4. The Council is an independent, self-funding
organisation. It is regarded as a public body but it is not part
of the Department of Health or the NHS. All its operational financial
costs are funded by fees from registrants. The fees are set out
in the Health Professions Council (Registrations and Fees) Rules
2003 and any fee increase is subject to a consultation and must
be approved by the Privy Council. From time to time, grants are
received from the Department of Health in relation to specific
projects.[5]
5. In its most recent annual report, the HCPC
describes 2012-13 as "a year of significant growth and change",
during which, in August 2012, over 88,000 social workers transferred
onto their register.[6]
Even aside from taking on social workers the HCPC register
has been increasing-the HCPC report that, in the five years since
2008, net registrant numbers have risen by 20%, excluding the
registrants who transferred from the GSCC.[7]
Breadth of HCPC's role
6. The HCPC has a broad remit, covering 16 different
professions. The Committee asked the HCPC about the implications
of this in its oral evidence session. Anna van der Gaag, the Chair
of the HCPC, said:
The key thing here is that we work very closely
with a large number of partners who are drawn from the professions
themselves, as well as from other disciplines. We have both lay
partners and professional partners who work with us on a sessional
basis and are involved in the day-to-day decision making of the
regulator. They are the ones who handle things right from the
registration process, so deciding who comes on to the register,
through to visits to universities, so approval and quality assurance
of education programmes, and all the fitness-to-practise work
that we do. The system could not operate without the expertise
of those individuals. Obviously, the recruitment, training and
quality assurance processes for those partners are important to
how we work. [8]
7. The HCPC argued that it was more than just
16 sub-regulators joined together:
From day 1, the organisation was set up where
we do the things identically wherever possible; we try to not
be different for different professions. In that way I think you
get a very efficient regulator. When we started doing that, the
reaction of the professional bodies to the idea, for example,
that you could have the same sort of standards for the professions
was, "How can that possibly work, if at one end of the spectrum
you have clinical scientists and at the other end of the spectrum
you have arts therapists?" Our view was that you can set
up a regulator where you have common processes and systems, and
I think we have demonstrated that it really works very efficiently.[9]
8. Marc Seale, the HCPC's Chief Executive and
Registrar, said that in his view the HCPC operated efficiently
for three reasons:
The first is that if you have lots of professions
and professional bodies, you tend to try to come up with a degree
of consensus, so the extreme views—the very odd ways of
doing things—are eliminated and you get a good, solid centre.
The second is a technical thing that you avoid regulatory capture
by the professions that you are regulating, because one profession
does not have that huge influence on the regulator. The third
component is that you get economies of scale and therefore you
can deliver regulation very effectively as well.[10]
Regulation of social work
9. In August 2012, over 88,000 social workers
transferred onto the HCPC's register.[11]
The PSA argue that the HCPC's performance in 2012-13 was particularly
notable given that it completed this transfer within this period.[12]
Social workers in England now account for 26.8% of the HCPC's
register, and 44.3% of its total Fitness to Practise cases; 0.88%
of registered social workers were subject to concerns.[13]
10. Anna van der Gaag described the steps that
had been taken to prepare for taking on this new responsibility:
Certainly in terms of our own governance, we
have been very fortunate. We have a social worker on the governing
council, so clearly we get expertise at a strategic, oversight
level. In terms of having the right expertise in the right place
at the right time, we have an established record on engagement
and communication, and on making sure that, where we need expertise,
we seek it out. We make no pretence of knowing about social work
practice, but we make sure that we bring in experts from the field
and recruit them as our partners, as Marc has said. If we have
to develop standards, we make sure that we have people from all
elements and areas of the profession involved in that process.[14]
11. When asked about how the HCPC handles the
arguably more subjective nature of judgements in social work when
compared to some other clinical professions, Dr van der Gaag responded
as follows:
I think that that is an important point. I do
see that there will be circumstances in which there will be much
clearer objective parameters around a judgment, and others where
the nature of the relationship—how it is interpreted and
how it is understood—will be very difficult, because there
will often be diametrically opposed views on that relationship.
That certainly is the case in social work practice, and we would
be very aware of it. I think it would also be the case in other
disciplines—perhaps not to the same extent, but certainly
in psychology, occupational therapy, speech and language therapy,
and arts therapy—that there would be those perhaps more
subjective elements and judgments to be made.[15]
The assessment of the Professional
Standards Authority
12. In their written submission to the Committee,
the PSA report that:
In 2012/2013 the HCPC met all our standards of
good regulation. This demonstrated an improvement on 2011/2012
where we found that the HPC (as it was at the time) was not meeting
the third standard of good regulation for education and training.
We consider that the HCPC's performance in 2012/2013
is particularly notable as it completed the transfer of the register
of social workers in England during this period. This added over
80,000 registrants to the HCPC registers, making it the second
largest regulator in the health and care professions sector in
the UK.
Despite the considerable additional work involved
in preparing for and implementing the transfer of the regulation
of social workers in England, the HCPC has maintained its efficient
and effective performance across all areas of responsibility.
This noteworthy given the increase in the volume of allegations
it is handling and the expansion of its scope.[16]
13. The PSA's written evidence highlights findings
from an audit carried out in June 2013 of 100 cases that the HCPC
closed in the initial stages of its FtP investigation process,
which is part of the PSA's regular three-year cycle of risk-based
auditing. The PSA provide the following summary of this year's
audit of the HCPC:
In our previous audit of the initial stages of
the HPC's FtP processes, published in February 2010, we found
that they dealt with cases 'efficiently and effectively' and that
'the vast majority of decisions taken on cases were reasonable
and protected the public'.
Our conclusion from our 2013 audit was that the
general case work system operated by the HCPC demonstrates that
public protection is maintained. We identified a number of examples
of good practise, specifically around active case management and
progression of cases.
However we found areas for improvement in 53
of the 100 cases we audited, including 25 cases where we had concerns
about decision making and six cases where we considered there
were potential implications for public protection and/or maintaining
public confidence in the professions or the system of regulation.
The HCPC has outlined actions to address the areas of concern
we highlighted in report.[17]
14. At the Committee's evidence session with
the PSA in July 2013, the PSA raised the issue of health assessments
for registrants who had drink or drugs related convictions.[18]
Further detail is provided in the PSA Annual Performance Review
Report:
The HCPC commissioned research in August 2012
into the concepts of public protection and impairment of a registrant's
fitness to practise in relation to ill health. This was in response
to our earlier recommendation that regulators should routinely
request a health assessment for all registrants who are convicted
of a drug or drink-related offence. Following the consideration
of the results of the research in February 2013 the HCPC concluded
that it will continue with its approach of not routinely requesting
a health assessment in such cases but considering it on a case-by-case
basis. We are disappointed by this as we note that other regulators
have found that investigating convictions and cautions involving
drugs and alcohol has led to identifying an underlying health
and performance concern in the registrant which might otherwise
not have been apparent. However we note that the HCPC's decision
is based on evidence which it has assessed. We will continue to
keep this issue under review.[19]
15. Responding to a question about this in oral
evidence, the HCPC explained their position:
First, we very much agree with the PSA on the
seriousness of drink and drug-related offences. The issue for
us is more about how we deal with those cases. Our assertion is
that each case should be looked at individually: the circumstances
surrounding drink-driving, for example, can be very different
for different registrants and therefore the case-by-case approach
that we take is, we think, fair, proportionate and appropriate
for those on our register.
Having said that, we have set out clear criteria
in our guidance on where a drink or drug-related offence will
be taken through to an investigation stage—for example,
if it is a repeat offence; if the offence occurs during the course
of the registrant carrying out professional duties; if there is
any sense that there were aggravating circumstances, such as a
failure to provide a specimen or failure to co-operate with the
police; or if the penalty imposed exceeds the maximum mandatory
disqualification. We have those four criteria that automatically
lead to further investigation, but we must be absolutely clear
on whether the actual incident has an impact on fitness to practise.
There are instances where that is not the case, so to take a blanket
approach, in our view, is not the right approach.[20]
THE VIEW OF THE PROFESSIONS
16. The Committee received evidence from two
organisations representing professions that are regulated by the
HCPC-the Chartered Society of Physiotherapy, which represents
52,000 physiotherapists, physiotherapy students, and support workers,
and the Association of Educational Psychologists, which represents
2,750 Educational Psychologists registered with the HCPC. The
Association of Educational Psychologists outlines a number of
concerns about the HCPC's Fitness to Practise process. These include
feedback that "in some cases investigations are not carried
out thoroughly" and "Fitness to Practise issues are
dealt with inconsistently". They also raise concerns that
"within the HCPC there is only a partial understanding of
the work of educational psychologists" and "apparently
high staff turnover". The information was compiled by the
Association of Education Psychologists on the basis of feedback
from members.[21]
17. The Chartered Society of Physiotherapy (CSP)
reports that it believes "that the HCPC is an effective regulator,
which takes a proportionate approach and provides a sound regulatory
framework for physiotherapy and other Allied Health Professionals.
The model of being a regulator of a large number of professions
is one that works well, with distinct advantages, deriving from
its cross-professional approach, which are strongly in the public
interest".[22] However,
the CSP does highlight "certain areas for improvement"
in fitness to practise arrangements, including a need to bring
down waiting times, and concerns that the initial investigation
process is not always sufficiently robust, leading to potential
difficulties at fitness to practise hearings.[23]
Time taken to conclude Fitness
to Practise hearings
18. The HCPC wrote to us following the accountability
hearing, providing further information about the time taken to
conclude their Fitness to Practise hearings:
In 2012-13 the length of time taken for a matter
to be considered by an Investigating Committee Panel from the
standard of acceptance being met is a mean of six months and a
median of four months. For those cases which were referred to
a final hearing, the mean and median average from receipt of allegation
to consideration by an Investigating Committee Panel was seven
and five months respectively.
In 2012-13 the total length of time for a case
to conclude from receipt of allegation to conclusion at final
hearing was a mean average of 16 months and a median average of
14 months. 27 cases took in excess of 24 months from receipt of
allegation. The mean and median length of time from the date of
the Investigating Committee Panel to conclusion at final hearing
was a mean average of nine months and a median average of eight
months.
In 2012-13, the total length of time to close
all cases from the point a case was received to case closure at
different points (closure without consideration by an investigating
committee panel, closure by an investigating committee panel,
closure at final hearing) was a mean average of nine months and
a median average of six months.[24]
19. The PSA have reported to
us that in 2012-13 the HCPC met all its standards of good regulation.
It also stated that "the HCPC has maintained its efficient
and effective performance across all areas of responsibility."
The PSA consider that the HCPC's performance in 2012-13 is particularly
notable as it has completed the transfer of social workers during
this period, increasing the volume of allegations it is handling,
and expanding its scope.
20. The PSA has highlighted
the specific issue of routine health checks for registrants who
are convicted of drink or drug related offences. The HCPC has
argued that rather than introducing a blanket policy of health
checks, a case-by-case approach is more proportionate. We will
revisit this issue next year.
21. Evidence we received from
organisations representing professions registered by the HCPC
also raised some specific concerns about the HCPC's fitness to
practise processes. We recommend that the HCPC consider the individual
points raised in written evidence by these organisations, and
provide a response to those organisations, to ensure that their
feedback is used, where necessary, to improve processes.
22. We asked the HCPC to provide
us with further information on the length of time it takes to
conclude fitness to practise cases. The HCPC reported to us that
in 2012-13 the average total length of time to close all cases
was 9 months; the average length of time to conclude cases that
went through to a final hearing was 16 months. However, reporting
'average' timescales can conceal wide variations and certain cases
taking an unacceptably long time to resolve-indeed the HCPC report
that in 2012-13, 27 cases took in excess of 24 months to conclude.
We urge the HCPC to commit itself to a clear "start to end"
target setting out the maximum length of time it takes to conclude
its Fitness to Practise processes, and in our view the maximum
time should be 12 months. Such a target represents a commitment
from the HCPC to the patients and service users it aims to protect,
and to its registrants, and should be clearly communicated on
its website.
Revalidation or 'continuing fitness
to practise'
23. The HCPC's written evidence outlines on-going
work in the area of revalidation. It uses the term "continuing
fitness to practise" instead of revalidation, to describe
the steps taken by regulators (and others) to support fitness
to practise beyond the point of initial registration:
Since 2003, we have required registrants to renew
their registration every two years. Since 2006, registrants have
had a compulsory, statutory requirement to undertake continuing
professional development (CPD). Our standards for CPD are focused
on outcomes-the benefits of CPD to services users and quality
of care. These standards are linked to registration and are underpinned
by random audits. We consider that auditing is a proportionate
method of ensuring compliance. We can and do remove individuals
from the Register where our standards have not been met. We also
have in place requirements for those seeking to return to the
Register after a period out of practise.
Analysis of fitness to practise allegations against
registrants has shown that the majority of cases (72% in 2012-13)
are about conduct and professionalism with relatively few cases
purely about lack of competence. We have been undertaking a programme
of work and research to build the evidence base further and inform
decisions about how we approach the assessment of continuing fitness
to practise.
This has included or includes the following.
Research (2011) looking at perceptions of
professionalism by both students and educators and about why and
how professionalism and lack of professionalism may be identified.
A further study is on-going looking at methods for measuring and
tracking professionalism during training and beyond.
Research (2011) looking at the potential
value of service user and colleague feedback tools to provide
further external input on registrants continuing fitness to practise.
More in-depth analysis of existing fitness
to practise data (2012) to look at the characteristics of registrants
reaching final hearings and whether there are relationships with
variables such as age, gender, work setting and route to registration
which might suggest clear patterns of risk.
More in-depth analysis of the content, outcomes
and impact of the CPD standards and audits since 2006, including,
for example, the extent to which annual appraisals and service
user feedback form part of registrants' existing CPD portfolios.
We anticipate that the outcomes of these pieces
of work will inform whether and in what ways we might enhance
our existing approach to assessing registrants continuing fitness
to practise. For example, we might consider requiring registrants
to seek service user feedback to inform their learning and we
might want to consider whether we have sufficient information
on risk such that we might consider targeting our audits towards
'higher risk' groups. We consider that it is important that any
further developments in this area are evidence-based and proportionate.[25]
24. Dr van der Gaag gave further information
about the HCPC's approach to continuing fitness to practise in
oral evidence:
We have had the system in place since 2006 and
we ask our registrants to keep up to date; to keep a record of
their continuing professional development activities; and to make
sure that these activities benefit patients and service users
and have an impact on the quality of what they do. Those are the
clear and simple messages that we give to registrants. Those are
mandatory standards that have been in place since 2006.
Since 2008, we have been auditing a proportion
of those on the register to ensure compliance. If they are selected
for audit, they have to submit evidence to us, which is assessed
by trained assessors working in pairs. They make a judgment about
whether the profile is meeting the standards that we set. To date,
we have audited about 11,500 individuals, of which a very small
proportion have been removed from the register because they have
failed to meet the standards: 0.7% have been removed from the
register and a further 4% have voluntarily deregistered—having
been selected for audit, they have disengaged from the process.
We have now audited all the professions except social workers,
who have just recently come into regulation by HCPC, and some
of them are now in the second round of audits. In terms of compliance,
the numbers are pretty consistent across the 15 professions that
we regulate. The system is there to assess compliance....
...We emphasised the outcomes-focused approach,
which is about how continuing professional development activity
benefits service users and patients. It is about outcomes, not
the amount of activity undertaken. We also strongly emphasised
that reflection on practice—keeping a reflective diary and
thinking about the impact of learning activities on professional
practice—was a key element of the process.
We have been advocating the outcomes-focused
approach, the reflective approach, for the past six to seven years.
It has taken time to convince some of the professions of its value,
but the feedback we get now is that they recognise that the reflective
process and the outcomes-based approach add value and are a more
motivating force than a points system or an hours-based approach
to continuing professional development. We certainly want to do
more research—for example, into the impact of work setting
on CPD activity. We also want to look at differentials between
the professions—at the moment we do not see any great differentials
in terms of pass/fail, but we have more work that we want to do
in that respect.[26]
25. When asked whether they planned to include
patient feedback within their system of continuing fitness to
practise, and what challenges might be associated with doing that
across 16 different professions, Dr van der Gaag told us that:
A large number of our registrants, when they
submit their profiles to us, already include patient feedback
as one of the elements—one of the pieces of evidence. That
is something that they are already doing, and they have been doing
it since the first audits began in 2008.[27]
26. They then argued that there was no 'one size
fits all' solution in relation to patient feedback tools:
.... If you want to receive authentic and valuable
feedback from, say, somebody with a learning disability, somebody
who has had a stroke, or perhaps a young person who is coming
to use mental health services, you need different tools. The work
that we are doing now is around looking at the different types
of tools that have been developed and validated with different
client groups, rather than saying to our registrants, "We
want you to use one tool," which we believe will be, in the
end, a blunt instrument and will not say very much about the person's
view of the practitioner.
...These tools are much better used as developmental
assessments—so "formative" tools, in the language
of the report, rather than summative tools, which in a sense are
a yes or a no on performance. They are much better used when they
are part of a much more comprehensive feedback on a health professional's
performance. So, again, we are taking note of that research and
looking for a variety of ways of involving patients and service
users in giving feedback to our registrants. We don't think there
is a one size fits all.[28]
27. The HCPC told us that there
is no one-size-fits all solution to securing patient input into
their continuing fitness to practise processes. In our view this
should constitute an important part of any revalidation system,
and we urge the HCPC to continue their efforts to include such
feedback on a regular and consistent basis.
The Francis report
28. As the Committee set out last year in its
report After Francis: Making a Difference, healthcare professionals
have an unambiguous professional duty to raise with the relevant
authorities any concerns which they have about the safety and
quality of care being delivered to patients, and the Francis Report
has implications for all professional regulators:
The Francis Report demonstrated that failure
of professional responsibility was a key factor which contributed
to failures of care at the Mid Staffordshire NHS Trust. The Committee
has also constantly emphasised the importance of an open and accountable
professional culture in its own reports during this Parliament.[29]
29. The HCPC's annual report gives the following
overview of the impact of the Francis report on their organisation:
In February 2013 the report of the Public Inquiry
into failings in care at the Mid-Staffordshire NHS Foundation
Trust was published. We have begun to consider carefully what
action we might take to implement the report's recommendations.
For example, as part of our review of the standards of conduct,
performance and ethics we will want to strengthen our requirements
for registrants around reporting and escalating concerns about
poor practice. The work of the Inquiry will be of importance to
us on many levels, and we are looking at our own culture as well
as at our regulatory functions to see what changes we might make
to ensure that we are also putting patients and service users
first in all we do.[30]
30. In their evidence to the Committee, the PSA
discuss the implications of the Francis report for the HCPC:
The Francis Inquiry has thrown a spotlight on
the effectiveness of regulatory and supervisory organisations,
both individually and as part of a wider safety and quality structure.
One of the key lessons from this Inquiry, and the Government's
response, is that a regulator's effectiveness should be gauged
on its contribution to the achievement of the common goal of safe,
high-quality care, as well as on its fulfilment of particular
and focused statutory duties.
The HCPC have perhaps a greater challenge than
other professional regulators in this respect, due to the breadth
of their register with 16 different professions operating across
a variety of settings. The efficiency and effectiveness with which
it meets own statutory responsibilities is commendable. However,
in the future, regulators will also be judged by the extent to
which they work with others as part of the safety and quality
architecture of health and social care, for the benefit of patients,
service users and the wider public. This will require a more coordinated
approach and the Committee may wish to understand how the HCPC
plans to cooperate and collaborate with other organisations in
the future to achieve common regulatory outcomes.[31]
31. The HCPC's written evidence describes how
they work jointly with other regulators:
In order to carry out our regulatory functions
effectively we work with relevant organisations, sharing appropriate
information relating to registration and fitness to practise.
One way we do this is through memoranda of understanding and such
agreements are in place with a range of organisations including
the Care Quality Commission (CQC) and the regulators of social
workers in Northern Ireland, Scotland and Wales.[32]
32. We asked the HCPC whether Memoranda of Understanding
were sufficient. Marc Seale told us:
In my view MOUs are, frankly, interesting bits
of paper, but what you have to be concerned about is what is happening
on an operational level within the regulators. When something
comes up—for example, if we get a complaint against a medic
arriving at our door—do we do something about it and is
that information going across to other regulators? I think MOUs
are a fig leaf in terms of what we are doing. I also think that
there is a tendency—I have seen it from the Shipman inquiry
and various things—to say, "Oh, we are having meetings.
The chief executives are getting together and we do this once
a month." There is a lot of enthusiasm at the first and second
meetings, but gradually that disappears. What you have to do,
and what we as the regulator try to do, is to make those contacts
with other regulators. For example, we have picked up cases from
other regulators—for example in the US—that have been
in contact with us because we have had an individual on our register.
The person came off our register and then went off to the US and
did something totally inappropriate. Someone then said, "Actually,
they have now gone back to the UK," so those organisations
phone us up and make contact, because we know them.
To me, it is about personal contact, building
up that trust, and making sure that other regulators and organisations
know about your existence so that the information comes across
to you. Having meetings and MOUs is not going to achieve that.[33]
33. When asked what difference being a multi-professional
regulator made to linking in with different organisations, Marc
Seale argued that, if anything, it made it easier, because they
have "a bigger presence, so people are more likely to know
about us."[34] Dr
van der Gaag added that
We invest hugely in communication and engagement.
We see that as an absolutely essential part of what we do. In
terms of the professions that we regulate, we have an open-door
policy. If they want to contact us about anything at all, or raise
concerns with us that are perhaps at a macro level, we are there.
We have regular meetings, at all levels of the organisation, with
officers.
Equally, we need to be in touch with organisations
that are there to represent patients and service users. One initiative
that has come out of Francis is work that we are doing at the
moment with the Patients Association, where it is reviewing our
complaints processes. There will be huge learning from that. It
has set standards on complaints, and we want to know whether we
meet those standards and in what way could we improve from the
association's perspective. Obviously, our hope is that, by going
through that scrutiny process—we are the first regulator
to do so—there will be learning that we can share with our
colleagues in the other professional regulatory bodies. [35]
34. In November 2013, the HCPC published the
results of research it has carried out with the public:
The Health and Care Professions Council (HCPC)
is launching new research today which finds that a fifth of UK
adults have encountered behaviour from a health or care professional
that made them doubt their fitness to practise.
More than a quarter said the health or care professional
in question seriously or persistently failed to meet standards
whilst 16 per cent said they felt the professional failed to respect
the rights of a patient to make their own choices. Thirteen per
cent felt they were 'hiding mistakes' and a further nine per cent
felt they were exploiting vulnerable patients. One in twenty said
they had experienced or witnessed reckless or deliberately harmful
acts.
Despite these figures, just three out of ten
reported their concerns, with a further 73 per cent of adults
who would not know where to go to report concerning behaviour.
The data, released today supports research commissioned
by the HCPC earlier in the year into what the general public feel
they need protection from most. Findings from this report show
that Illegal drug taking and shoplifting were far more likely
to concern members of the public than convictions for drink driving.
Dishonesty and fraud were also key concerns for most.[36]
35. Anna van der Gaag gave more information about
this work in the Committee's oral evidence session, arguing that
although general awareness of regulators may be low, once people
want to make a complaint to the HCPC, they find navigating their
way through the system easier:
That is in fact one piece of work in quite a
long line of polling initiatives that we have commissioned or
undertaken over the years to try to gauge the public's understanding
of professional regulation, what it is there to do and how to
access it. All those reports say the same thing, which is that
there is a low level of awareness about this in general. Crucially,
however, there is also a clear steer that, once people need to
know where to go to make a complaint, they find it a much easier
route. General awareness is low, but once someone needs to make
a complaint they very quickly can either use the internet or find
out through their GP, their pharmacy or a number of other mechanisms,
where to come to make a complaint. It is about the general awareness
versus the specific route to making a complaint or raising a concern.
That was what the research was focusing on.[37]
36. Dr van der Gaag said that there was nevertheless
no room for complacency on this issue:
There is never any sense with us that we are
content. Of course, it would be better if there was a more general
awareness. Of course, it is important to make ourselves accessible
by, for example, looking at our language, both written and what
we put on the website, and making sure that there is literature
published in easy-read formats and in other languages. We are
doing that already but there is a lot more that we can still do
to make sure that we are accessible and that people can then contact
us and follow through with raising concerns. We would not be in
any way complacent about that. We are aware that this lack of
consciousness is a general issue for regulators.[38]
37. Marc Seale also said that powers within the
HCPC's legislation provide a useful means for the HCPC to investigate
complaints which have been raised with them, but which a registrant
may not wish to pursue further:
We have a power in our legislation called the
22(6) that enables myself as the registrar to make the complaint.
For example, if there are two biomedical scientists, and one of
them has concerns about the other who is working in the same laboratory,
but feels very uncomfortable about making the complaint themselves,
if they contact us, give us the right information and say, "Look,
I really don't want to go to the next stage," I, as the registrar,
make the allegation or complaint. That is a very efficient way
of dealing with this issue about, "Hang on, you are not actually
going to pick those ones up." It is a simple bit of legislation,
but it works very effectively.[39]
38. The Francis report has thrown
a spotlight on the role of health and care regulators in ensuring
public protection, as healthcare professionals have an unambiguous
professional duty to raise with the relevant authorities any concerns
which they have about the safety and quality of care being delivered
to patients. For the effective regulation of clinical and caring
professions, regulators need to be visible and accessible to registrants,
and also to patients and members of the public who wish to raise
concerns about patient safety. Regulatory bodies must also collaborate
effectively between themselves. We recommend that the HCPC continues
to monitor its own profile both with patients and service users,
with professionals, and with other relevant organisations, and
we will seek further evidence of the progress the HCPC and other
professional regulators have made in implementing the recommendations
of the Francis report at our next accountability hearings in the
autumn.
4 HCPC (HCPC 0001), paras 2.3-2.5 Back
5
HCPC, Annual Report and Accounts 2012-13, p4 Back
6
HCPC, Annual Report and Accounts 2012-13, p3 Back
7
HCPC, Annual Report and Accounts 2012-13, p5 Back
8
Q2 Back
9
Q3 Back
10
Q3 Back
11
HCPC, Annual Report and Accounts 2012-13, p3 Back
12
Professional Standards Authority, (HCP 0002) para 2.2 Back
13
HCPC, Fitness to Practise Annual Report 2013, p13 Back
14
Q21 Back
15
Q22 Back
16
Professional Standards Authority, (HCP 0002) para 2.1-2.3 Back
17
Professional Standards Authority, (HCP 0002), paras 3.2 - 3.4 Back
18
Oral evidence taken on 9 July 2013, HC 528-I, qq7-9 Back
19
Professional Standards Authority, Annual Report and Accounts and Performance Review Report 2012-13,
p 83, para 16.36 Back
20
Q8 Back
21
Association of Educational Psychologists (HCP 0008), paras 3-9 Back
22
Chartered Society of Physiotherapy, (HCP 0009), summary, p1 Back
23
Chartered Society of Physiotherapy, (HCP 0009), para 2.6 Back
24
HCPC supplementary evidence (HCP 0013) pp 4.5-4.7 Back
25
HCPC (HCPC 0001)paras 4.1 - 4.5 Back
26
Q10 Back
27
Q13 Back
28
Q13 Back
29
Health Committee, Third Report of Session 2013-14, After Francis - Making a Difference,
HC 657, para 16-17 Back
30
HCPC, Annual Report and Accounts 2012-13, p3 Back
31
Professional Standards Authority, (HCP 0002) paras 5.1 - 5.2 Back
32
HCPC (HCP 0001), para 2.6 Back
33
Q18 Back
34
Q19 Back
35
Q19 Back
36
HCPC launches new research and takes steps to protect the public,
HCPC press release, 20 November 2013 Back
37
Q16 Back
38
Q17 Back
39
Q17 Back
|
